Perception and practice of sublingual immunotherapy among practicing allergists.
BACKGROUND
Currently, little information is available regarding who is using sublingual immunotherapy (SLIT) in the United States, what product they may be using, how they are dosing that product, and what perceived effect it may be having on patients.


OBJECTIVE
To gather information regarding the perception and use of SLIT among practicing allergists in the United States.


METHODS
On behalf of the American College of Allergy, Asthma and Immunology (ACAAI) Immunotherapy and Diagnostics Committee, an electronic survey was sent to all practicing allergists of the ACAAI in March 2007.


RESULTS
The survey response rate was 25.7% (828/3,217) in which 92.5% of the respondents (766/828) practiced in the United States. For 61.7% (471/763) the most cited reason for not using SLIT was lack of approval by the Food and Drug Administration (FDA). If SLIT were an FDA-approved form of immunotherapy, 65.7% would use it to treat allergic rhinitis, 45.5% would use SLIT to treat patients younger than 5 years, and 40.9% would use it to treat moderate to severe asthma. A total of 5.9% (45/766) of US allergists reported using SLIT. Most perceived SLIT to be as effective (44.7%) or more effective (10.5%) than subcutaneous immunotherapy (SCIT). Most allergists who used SLIT (65.9%) had it reimbursed by patients paying out of pocket. The most commonly used extract (79.1%) was a commercially available extract used for SCIT. Some practitioners (53.5%) required their patients to administer doses of SLIT in their office, but 81.8% only required that this be done with the first dose. Practitioners gave epinephrine injectors to 41.5% of their patients receiving SLIT.


CONCLUSIONS
Although only 5.9% of US allergists reported using SLIT, most of the 828 surveyed (766 US allergists) viewed SLIT as safe and effective and would consider using SLIT if it were an FDA-approved therapy.
Tucker
Mark H
MH
Department of Allergy and Immunology, Naval Medical Center, San Diego, California 92106, USA. mhtucker@pol.net
Tankersley
Michael S
MS
D000286:Administration, Sublingual; D000485:Allergens / Q000276:immunology*; D003888:Desensitization, Immunologic / Q000379:methods* / Q000706:statistics & numerical data; D017277:Drug Approval; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology / Q000628:therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States
D000485:Allergens